Temporary Staffing Spend Reduction & Workforce Optimisation Programme
Summary
The Temporary Staffing Team at Liverpool University Hospitals NHS Foundation Trust delivered a £13.8m reduction in temporary staffing spend in 2024/25, with a further £4m reduction in Q1 2025/26. By introducing escalation processes, real-time dashboards, and targeted workforce initiatives, the Trust reduced reliance on agency staff, eliminated off-framework usage, and achieved the highest nursing cap compliance in Cheshire and Merseyside. The project expanded the internal bank, supported staff development through CARE and Preceptorship Lite, and created a sustainable model for safer staffing and long-term workforce resilience.
The Challenge
The Trust faced rising temporary staffing costs and over-reliance on agency workers, leading to financial strain and governance risks. Processes were fragmented, limiting managers’ ability to act quickly on staffing pressures. Bank worker engagement was low, leaving internal resources underused. Temporary staffing was largely reactive, focused on filling immediate gaps rather than planning ahead. This created instability across the workforce, inconsistent delivery of care, and reduced capacity for investment in permanent staff.
The Solution
The project brought together temporary staffing, clinical leaders, finance, business intelligence, rostering, and agency partners. A high-priority escalation process empowered local managers to make timely staffing decisions, supported by weekly non-core spend assurance meetings with senior clinicians and finance. Real-time dashboards, developed with BI and the bank team, improved visibility and accountability. The team worked with RLDatix to optimise Allocate Optima, improving roster control and access to real-time workforce data. Agency partnerships were rationalised, rates renegotiated, and off-framework usage eliminated. Initiatives such as CARE and Preceptorship Lite supported bank worker development, strengthened recruitment pipelines, and reduced reliance on agencies.
Results & Next Steps
The programme delivered £13.8m savings in 2024/25 and £4m in Q1 2025/26. Bank fill rates increased by 21%, while agency demand for registered nurse shifts reduced by 41%. The Trust achieved the highest nursing cap compliance in Cheshire and Merseyside and eliminated off-framework agency use, including for resident doctors. CARE supported 114 workers into permanent roles, and 83 clinical staff were developed through bank-first roles. Preceptorship Lite provided a pathway for newly qualified nurses to complete preceptorship via bank work. National recognition includes becoming the only NHS provider accepted onto HealthTrust Europe’s Total Workforce Solutions framework. A shared regional mental health bank demonstrates scalability. All interventions, including dashboards and assurance processes, are now embedded into Trust policy, ensuring long-term impact and continued workforce improvement.
